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Article(id=1240722570127921239, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240722566957027366, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202502361, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1739980800000, receivedDateStr=2025-02-20, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773740912228, onlineDateStr=2026-03-17, pubDate=1760025600000, pubDateStr=2025-10-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773740912228, onlineIssueDateStr=2026-03-17, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773740912228, creator=13701087609, updateTime=1773740912228, updator=13701087609, issue=Issue{id=1240722566957027366, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='19', pageStart='3457', pageEnd='3648', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=1, specialIssue=0, createTime=1773740911472, creator=13701087609, updateTime=1773740981732, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1240722861736906836, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240722566957027366, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1240722861736906837, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240722566957027366, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=3573, endPage=3578, ext={EN=ArticleExt(id=1240722570874507396, articleId=1240722570127921239, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Economic burden of hospitalized cases of mycoplasma pneumonia in Wuhan in 2023, columnId=1228016567846367388, journalTitle=Modern Preventive Medicine, columnName=Health Policy and Management, runingTitle=null, highlight=null, articleAbstract=

Objective To understand the economic burden of hospitalized cases of mycoplasma p neumonia (MPP) in Wuhan in 2023, and to provide a scientific basis for the formulation and improvement of public health prevention and control policies. Methods A questionnaire survey was conducted on the hospitalized cases of MPP in Wuhan from January to October 2023. Non-parametric tests were used to analyze the differences in direct, indirect, and total economic burden among different groups of patients due to MPP. Multivariable Logistic regression was used to analyze the related factors affecting economic burden. Results A total of 342 cases of hospitalized MPP were investigated. The total economic burden was higher in severe cases and those with symptoms of fever, cough, and headache (P<0.001). Seeking medical treatment at a tertiary general hospital in a remote urban area (OR=0.156, 95% CI: 0.032-0.764), being aged 19-59 years (OR=13.706, 95% CI: 4.697-39.999), being aged ≥60 years (OR=57.661, 95% CI: 13.283-250.315), hospitalization lasting more than 7 days (OR=3.244, 95% CI: 1.624-6.479), and caregivers missing work for more than 7 days (OR=8.323, 95% CI: 4.108-16.862) were identified as factors associated with the total economic burden (P<0.05). Conclusion Visiting a children’s specialized hospital, severe cases, having symptoms of fever, cough, and headache, increasing age, length of hospital stay, and days of caregiver’s lost work all bring heavier economic burdens to patients. Public health policy interventions such as strengthening clinical diagnosis and treatment, and improving the medical security system should be strengthened to reduce the economic burden on patients.

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目的 了解武汉市2023年肺炎支原体肺炎（mycoplasma pneumoniae pneumonia,MPP）住院病例经济负担，为公共卫生防控政策制定和完善提供科学依据。方法 抽取武汉市2023年1—10月MPP住院病例为研究对象进行问卷调查，采用非参数检验分析不同组别患者因MPP住院造成的直接、间接及总经济负担的差异，同时采用多因素logistic回归分析影响经济负担相关因素。结果 共调查342例MPP住院病例，重型病例、具有发热以及咳嗽和头疼症状的住院病例总经济负担较高（P<0.001）。就诊远城区三级综合医院（OR=0.156，95%CI: 0.032～0.764）、年龄处于19～59岁（OR= 13.706，95%CI: 4.697～39.999）、≥60岁（OR=57.661，95%CI: 13.283～250.315）、住院日超过7日（OR=3.244，95%CI:1.624～6.479）、陪护误工工作日超过7日（OR=8.323，95%CI: 4.108～16.862）为影响总经济负担的相关因素（P<0.05）。结论 就诊于儿童专科医院、重型病例、具有发热以及咳嗽和头疼症状、年龄的增加、住院日以及陪护误工工作日的延长等因素，带给患者更沉重的经济负担，应加强临床诊疗、完善医疗保障体系等公共卫生政策干预，减轻患者经济负担。

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张丽杰，E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=3epUFvxDD6recFlUnVbKfw==, magXml=8FTXaLgm5J835o4d9tgqxg==, pdfUrl=null, pdf=4MC1NZYGC6TqOQQzynODXg==, pdfFileSize=732708, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=IwaabMJ7fxgyIu4KhYMJyQ==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=SFv1LZuz0qiYfd2RYLu5DQ==, mapNumber=null, authorCompany=null, fund=null, authors=

沈惠与陈邦华为共同第一作者

沈惠（1995—），女，硕士，公卫医师，研究方向：疾病预防与控制；

陈邦华（1976—），男，硕士，主任医师，研究方向：现场流行病学；

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沈惠（1995—），女，硕士，公卫医师，研究方向：疾病预防与控制；

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沈惠（1995—），女，硕士，公卫医师，研究方向：疾病预防与控制；

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陈邦华（1976—），男，硕士，主任医师，研究方向：现场流行病学；

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陈邦华（1976—），男，硕士，主任医师，研究方向：现场流行病学；

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Chinese Medical Record, 2022, 23(6): 59-61.(In Chinese), articleTitle=Analysis on influencing factors of hospitalization expenses of early and late neonatal pneumonia, refAbstract=null), Reference(id=1240933504775680497, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240722570127921239, doi=null, pmid=null, pmcid=null, year=2024, volume=51, issue=10, pageStart=1821, pageEnd=1827, url=null, language=null, rfNumber=[20], rfOrder=34, authorNames=薛同斌, 田帝, 周苑, journalName=现代预防医学, refType=null, unstructuredReference=薛同斌，田帝，周苑，等.疾病诊断相关分组支付方式改革背景下慢性阻塞性肺疾病患者住院费用变化趋势及影响因素分析[J].现代预防医学，2024，51（10）：1821-1827., articleTitle=疾病诊断相关分组支付方式改革背景下慢性阻塞性肺疾病患者住院费用变化趋势及影响因素分析, refAbstract=null), Reference(id=1240933504884732408, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240722570127921239, doi=null, pmid=null, pmcid=null, year=2024, volume=51, issue=10, pageStart=1821, pageEnd=1827, url=null, language=null, rfNumber=[20], rfOrder=35, authorNames=Xue TB, Tian D, Zhou Y, journalName=Modern Preventive Medicine, refType=null, unstructuredReference=Xue TB, Tian D, Zhou Y, et al. 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Modern Preventive Medicine, 2024, 51(10): 1821-1827.(In Chinese), articleTitle=Trends and influencing factors of hospitalization expenses for patients with chronic obstructive pulmonary disease under the background of DRG reform, refAbstract=null)], funds=[Fund(id=1240933500430381354, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240722570127921239, awardId=2024YFC2311500, language=CN, fundingSource=国家重点研发计划(2024YFC2311500), fundOrder=null, country=null), Fund(id=1240933500514267439, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240722570127921239, awardId=82341034, language=CN, fundingSource=国家自然科学基金(82341034), fundOrder=null, country=null), Fund(id=1240933500635902260, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240722570127921239, awardId=102393220020010000027, language=CN, fundingSource=中国现场流行病学培训项目(102393220020010000027), fundOrder=null, country=null), Fund(id=1240933500770119998, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240722570127921239, awardId=01063, language=CN, fundingSource=国家疾病预防控制局-公共卫生人才培养支持项目(01063), fundOrder=null, country=null), Fund(id=1240933500887560516, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240722570127921239, awardId=null, language=CN, fundingSource=武汉市公共卫生重点学科-《新（突）发传染病监测预警》, fundOrder=null, country=null)], companyList=[AuthorCompany(id=1240933496420626575, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240722570127921239, xref=1., ext=[AuthorCompanyExt(id=1240933496424820880, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240722570127921239, companyId=1240933496420626575, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Wuhan Center for Disease Control and Prevention, Wuhan, Hubei 430024,China), AuthorCompanyExt(id=1240933496429015185, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240722570127921239, companyId=1240933496420626575, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.武汉市疾病预防控制中心，湖北 武汉 430024)]), AuthorCompany(id=1240933496496124053, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240722570127921239, xref=2., ext=[AuthorCompanyExt(id=1240933496500318358, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240722570127921239, companyId=1240933496496124053, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.中国疾病预防控制中心，北京 100050)])], figs=[ArticleFig(id=1240933499541188867, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240722570127921239, language=EN, label=Figure 1, caption=The time distribution of 342 hospitalized MPP cases, figureFileSmall=XxxQHcTVJxK4TUxvYv86Cw==, figureFileBig=D/1Qs+3kdjfL/M0ksmBgYg==, tableContent=null), ArticleFig(id=1240933499625074951, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240722570127921239, language=CN, label=图1, caption=342例MPP的住院病例时间分布, figureFileSmall=XxxQHcTVJxK4TUxvYv86Cw==, figureFileBig=D/1Qs+3kdjfL/M0ksmBgYg==, tableContent=null), ArticleFig(id=1240933499725738253, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240722570127921239, language=EN, label=Table 1, caption=

Variable assignment in multivariable logistic regression analysis

, figureFileSmall=null, figureFileBig=null, tableContent=
变量赋值
医疗机构类型1=儿童专科医院，2=市区三级综合医院，
3=远城区三级综合医院
年龄（岁）1=≤5，2=6～18，3=19～59，4=≥60
临床分型1=轻型，2=重型
住院日（d）1=≤7，2=>7
陪护误工工作日（d）1=≤7，2=>7
是否发热、咳嗽、头疼1=是，2=否
), ArticleFig(id=1240933499818012947, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240722570127921239, language=CN, label=表1, caption=

多因素logistic回归分析变量赋值

, figureFileSmall=null, figureFileBig=null, tableContent=
变量赋值
医疗机构类型1=儿童专科医院，2=市区三级综合医院，
3=远城区三级综合医院
年龄（岁）1=≤5，2=6～18，3=19～59，4=≥60
临床分型1=轻型，2=重型
住院日（d）1=≤7，2=>7
陪护误工工作日（d）1=≤7，2=>7
是否发热、咳嗽、头疼1=是，2=否
), ArticleFig(id=1240933499922870552, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240722570127921239, language=EN, label=Table 2, caption=

Economic burden of hospitalized MPP cases in Wuhan in 2023

, figureFileSmall=null, figureFileBig=null, tableContent=
特征例数（%）直接经济负担
［元，M（P25
，P75）］		Z/H值P值间接经济负担
［元，M（P25
，P75）］		Z/H值P值总经济负担
［元，M（P25，P75）］		Z/H值P值
就诊医疗机构106.30<0.00113.240.00187.08<0.001
儿童专科医院135(39.5)6 880.05
(5 637.06,8 540.24)		938.71
(782.26，1 564.52)		7 811.46
(6 320.48，10 130.17)
市区三级综合医院128(37.4)9 743.93
(6 616.20，12 856.65)		312.9 (0，1 486.30)10 546.51 (7 756.03，
13 117.42)
远城区三级综合医院79(23.1)4 302.19
(3 368.17，5 420.82)		782.26 (0，1 564.52)5 271.09 (3 991.75，
6 795.50)
性别0.190.661.920.060.060.95
男性183(53.5）6 838.25
(5 153.65，9 982.39)		1 095.16
(0，1 564.52)		7 972.77
(5 849.67，10 903.06)
女性159(46.5）6 948.96
(4 974.73，10 636.88)		782.26
(0，1 408.07)		8 057.24
(5 721.93，11 247.04)
年龄（岁）66.82<0.00149.05<0.00148.21<0.001
0～5113(33）5 619.34
(4 122.07，8 103.10)		938.71
(0，1 564.52)		6 292.82
(5 116.95，9 667.62)
6～18135(39.5）6 515.70
(5 108.59，7 845.28)		1 095.16
(625.81，1 564.52)		7 731.22
(6 148.29，10 023.02)
19～5961(17.8）9 631.81
(7 466.95，12 661.56)		0 (0，469.36)10 024.35
(7 533.55，12 661.56)
≥6033(9.6）11 649.53
(10 003.01，14 445.04)		0 (0，1 095.16)11 987.17
(10 318.64，14 848.60)
临床分型12.42<0.0012.920.0915.97<0.001
轻型285(83.3）6 649.17
(4 929.02，9 599.81)		782.26 (0，1 408.07)7 725.76
(5 534.04，10 628.49)
重型57(16.7）9 043.16
(6 143.08，11 612.71)		1 095.16 (156.45，2 033.88)10 308.51
(7 533.55，12 467.59)
是否自行购药2.990.080.360.552.110.15
是185(54.1）6 528.73
(4 925.75，9 633.77)		938.71
(0，1 564.52)		7 725.76
(5 738.66，10 556.07)
否157(45.9）7 499.45
(5 255.94，10 728.53)		782.26 (0，1 564.52)8 356.20
(5 890.18，11 264.12)
住院前是否在任何门诊看病1.460.231.150.281.360.24
是239(69.9）7 097.32
(5 346.11，9 982.39)		782.26 (0，1 564.52)8 308.16
(5 897.41，11 098.17)
否103(30.1）6 189.13
(4 584.32，10 780.95)		782.26 (0，1 251.62)7 353.53
(5 241.92，11 093.85)
住院日（d）22.35<0.0015.170.0227.81<0.001
≤7237(69.3）6 315.57
(4 879.78，8 974.15)		782.26 (0，1 251.62)7 466.95
(5 373.41，10 024.35)
>7105(30.7）8 629.33
(6 021.80，12 594.19)		1 095.16 (0，1 564.52)10 096.53
(7 419.29，13 015.82)
病人误工或缺课多少工作日（d）0.200.6626.75<0.0013.370.07
≤7216(63.2）6 858.56
(5 019.35，9 851.48)		782.26 (0，1 095.16)7 728.68
(5 689.18，10 632.69)
>7126(36.8）6 909.95
(5 153.65，10 405.00)		1 329.84 (0，2 190.33)8 810.77
(6 115.29，11 582.37)
陪护人数9.160.0172.27<0.0016.370.04
039(11.4）9 455.53
(5 849.67，11 644.37)		0 (0，0)9 455.53
(6 114.73，11 644.37)
1176(51.5）6 508.64
(4 902.77，9 765.16)		782.26 (0，1 251.62)7 459.93
(5 490.09，10 964.55)
≥2127(37.1）6 849.80
(5 373.41，9 553.66)		1 251.62
(782.26，1 877.43)		8 416.68
(6 115.29，11 118.67)
陪护误工工作日（d）4.180.04225.31<0.00129.09<0.001
≤7230(67.3）6 682.02
(4 967.17，9 807.90)		312.90 (0，782.26)7 208.49
(5 346.11，10 308.51)
>7112(32.7）7 731.03
(5 548.40，10 890.81)		1 799.20
(1 564.52，2 346.78)		9 999.73
(7 489.64，12 603.66)
是否发热34.00<0.0011.470.2228.18<0.001
否145(42.4）5 351.39 (4 032.29，9 369.80)782.26 (0，1 564.52)6 282.71
(4 747.97，10 318.64)
是197(57.6）7 708.21 (6 143.08，10 636.88)938.71 (0，1 408.07)8 809.25
(6 865.07，11 264.12)
是否咳嗽48.86<0.0010.030.8638.16<0.001
否99(28.9）4 615.50
(3 511.88，6 805.14)		782.26 (0，1 564.52)5 849.67
(4 467.17，8 839.02)
是243(71.1）7 708.21
(5 908.74，10 750.79)		782.26 (0，1 408.07)8 790.59
(6 660.37，11 280.11)
是否头疼26.20<0.0013.750.0519.04<0.001
否309(90.4）6 528.73
(4 936.27，9 461.52)		782.26 (0，1 564.52)7 731.22
(5 662.04，10 636.88)
是33(9.6）10 956.56
(9 058.01，13 424.57)		312.90 (0，1 095.16)11 247.69
(9 058.01，14 398.57)
是否流涕3.580.060.290.592.480.12
否272(79.5）6 709.98
(4 894.71，10 013.68)		782.26 (0，1 564.52)7 806.89
(5 655.36，11 059.95)
是70(20.5）7 762.52
(5 637.06，9 867.05)		860.49 (0，1 408.07)8 701.97
(6 506.58，11 118.67)
是否咽疼5.460.020.690.413.680.06
否325(95.0）6 803.05
(5 003.48，9 895.06)		782.26 (0，1 564.52)7 811.46
(5 738.66，11 026.04)
是17(5.0）9 455.53
(7 845.28，10 780.95)		312.90 (0，1 564.52)10 572.15
(8 495.20，11 093.85)
合计342
(100.0)		6 871.42
(5 107.03，10 003.01)		782.26(0，1 564.52)8 015.00
(5 773.69，11 093.85)
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2023年武汉市MPP住院病例经济负担情况比较

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特征例数（%）直接经济负担
［元，M（P25
，P75）］		Z/H值P值间接经济负担
［元，M（P25
，P75）］		Z/H值P值总经济负担
［元，M（P25，P75）］		Z/H值P值
就诊医疗机构106.30<0.00113.240.00187.08<0.001
儿童专科医院135(39.5)6 880.05
(5 637.06,8 540.24)		938.71
(782.26，1 564.52)		7 811.46
(6 320.48，10 130.17)
市区三级综合医院128(37.4)9 743.93
(6 616.20，12 856.65)		312.9 (0，1 486.30)10 546.51 (7 756.03，
13 117.42)
远城区三级综合医院79(23.1)4 302.19
(3 368.17，5 420.82)		782.26 (0，1 564.52)5 271.09 (3 991.75，
6 795.50)
性别0.190.661.920.060.060.95
男性183(53.5）6 838.25
(5 153.65，9 982.39)		1 095.16
(0，1 564.52)		7 972.77
(5 849.67，10 903.06)
女性159(46.5）6 948.96
(4 974.73，10 636.88)		782.26
(0，1 408.07)		8 057.24
(5 721.93，11 247.04)
年龄（岁）66.82<0.00149.05<0.00148.21<0.001
0～5113(33）5 619.34
(4 122.07，8 103.10)		938.71
(0，1 564.52)		6 292.82
(5 116.95，9 667.62)
6～18135(39.5）6 515.70
(5 108.59，7 845.28)		1 095.16
(625.81，1 564.52)		7 731.22
(6 148.29，10 023.02)
19～5961(17.8）9 631.81
(7 466.95，12 661.56)		0 (0，469.36)10 024.35
(7 533.55，12 661.56)
≥6033(9.6）11 649.53
(10 003.01，14 445.04)		0 (0，1 095.16)11 987.17
(10 318.64，14 848.60)
临床分型12.42<0.0012.920.0915.97<0.001
轻型285(83.3）6 649.17
(4 929.02，9 599.81)		782.26 (0，1 408.07)7 725.76
(5 534.04，10 628.49)
重型57(16.7）9 043.16
(6 143.08，11 612.71)		1 095.16 (156.45，2 033.88)10 308.51
(7 533.55，12 467.59)
是否自行购药2.990.080.360.552.110.15
是185(54.1）6 528.73
(4 925.75，9 633.77)		938.71
(0，1 564.52)		7 725.76
(5 738.66，10 556.07)
否157(45.9）7 499.45
(5 255.94，10 728.53)		782.26 (0，1 564.52)8 356.20
(5 890.18，11 264.12)
住院前是否在任何门诊看病1.460.231.150.281.360.24
是239(69.9）7 097.32
(5 346.11，9 982.39)		782.26 (0，1 564.52)8 308.16
(5 897.41，11 098.17)
否103(30.1）6 189.13
(4 584.32，10 780.95)		782.26 (0，1 251.62)7 353.53
(5 241.92，11 093.85)
住院日（d）22.35<0.0015.170.0227.81<0.001
≤7237(69.3）6 315.57
(4 879.78，8 974.15)		782.26 (0，1 251.62)7 466.95
(5 373.41，10 024.35)
>7105(30.7）8 629.33
(6 021.80，12 594.19)		1 095.16 (0，1 564.52)10 096.53
(7 419.29，13 015.82)
病人误工或缺课多少工作日（d）0.200.6626.75<0.0013.370.07
≤7216(63.2）6 858.56
(5 019.35，9 851.48)		782.26 (0，1 095.16)7 728.68
(5 689.18，10 632.69)
>7126(36.8）6 909.95
(5 153.65，10 405.00)		1 329.84 (0，2 190.33)8 810.77
(6 115.29，11 582.37)
陪护人数9.160.0172.27<0.0016.370.04
039(11.4）9 455.53
(5 849.67，11 644.37)		0 (0，0)9 455.53
(6 114.73，11 644.37)
1176(51.5）6 508.64
(4 902.77，9 765.16)		782.26 (0，1 251.62)7 459.93
(5 490.09，10 964.55)
≥2127(37.1）6 849.80
(5 373.41，9 553.66)		1 251.62
(782.26，1 877.43)		8 416.68
(6 115.29，11 118.67)
陪护误工工作日（d）4.180.04225.31<0.00129.09<0.001
≤7230(67.3）6 682.02
(4 967.17，9 807.90)		312.90 (0，782.26)7 208.49
(5 346.11，10 308.51)
>7112(32.7）7 731.03
(5 548.40，10 890.81)		1 799.20
(1 564.52，2 346.78)		9 999.73
(7 489.64，12 603.66)
是否发热34.00<0.0011.470.2228.18<0.001
否145(42.4）5 351.39 (4 032.29，9 369.80)782.26 (0，1 564.52)6 282.71
(4 747.97，10 318.64)
是197(57.6）7 708.21 (6 143.08，10 636.88)938.71 (0，1 408.07)8 809.25
(6 865.07，11 264.12)
是否咳嗽48.86<0.0010.030.8638.16<0.001
否99(28.9）4 615.50
(3 511.88，6 805.14)		782.26 (0，1 564.52)5 849.67
(4 467.17，8 839.02)
是243(71.1）7 708.21
(5 908.74，10 750.79)		782.26 (0，1 408.07)8 790.59
(6 660.37，11 280.11)
是否头疼26.20<0.0013.750.0519.04<0.001
否309(90.4）6 528.73
(4 936.27，9 461.52)		782.26 (0，1 564.52)7 731.22
(5 662.04，10 636.88)
是33(9.6）10 956.56
(9 058.01，13 424.57)		312.90 (0，1 095.16)11 247.69
(9 058.01，14 398.57)
是否流涕3.580.060.290.592.480.12
否272(79.5）6 709.98
(4 894.71，10 013.68)		782.26 (0，1 564.52)7 806.89
(5 655.36，11 059.95)
是70(20.5）7 762.52
(5 637.06，9 867.05)		860.49 (0，1 408.07)8 701.97
(6 506.58，11 118.67)
是否咽疼5.460.020.690.413.680.06
否325(95.0）6 803.05
(5 003.48，9 895.06)		782.26 (0，1 564.52)7 811.46
(5 738.66，11 026.04)
是17(5.0）9 455.53
(7 845.28，10 780.95)		312.90 (0，1 564.52)10 572.15
(8 495.20，11 093.85)
合计342
(100.0)		6 871.42
(5 107.03，10 003.01)		782.26(0，1 564.52)8 015.00
(5 773.69，11 093.85)
), ArticleFig(id=1240933500140974367, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240722570127921239, language=EN, label=Table 3, caption=

Multivariable logistic regression analysis of total economic burden

, figureFileSmall=null, figureFileBig=null, tableContent=
影响因素βWaldχ2值P值OR值（95%CI）
就诊医疗机构
儿童专科医院*-----
市区三级综合医院-0.2940.3930.5590.4550.745(0.345～1.610)
远城区三级综合医院-1.8610.8125.2500.0220.156(0.032～0.764)
年龄（岁）
0～5*-----
6～180.3070.3370.8280.3631.359(0.702～2.634)
19～592.6180.54622.952<0.00113.706(4.697～39.999)
≥604.0550.74929.299<0.00157.661(13.283～250.315)
临床分型
轻型*-----
重型0.7040.4092.9650.0852.022(0.907～4.507)
住院日（d）
≤7*-----
>71.1770.35311.1200.0013.244(1.624～6.479)
陪护误工工作日（d）
≤7*-----
>72.1190.36034.598<0.0018.323(4.108～16.862)
发热
否*-----
是0.7200.3943.3430.0672.054(0.950～4.444)
咳嗽
否*-----
是0.9000.7081.6170.2042.460(0.614～9.852)
头疼
否*-----
是0.7060.5811.4780.2242.026(0.649～6.323)
), ArticleFig(id=1240933500220666147, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240722570127921239, language=CN, label=表3, caption=

总经济负担的多因素logistic回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
影响因素βWaldχ2值P值OR值（95%CI）
就诊医疗机构
儿童专科医院*-----
市区三级综合医院-0.2940.3930.5590.4550.745(0.345～1.610)
远城区三级综合医院-1.8610.8125.2500.0220.156(0.032～0.764)
年龄（岁）
0～5*-----
6～180.3070.3370.8280.3631.359(0.702～2.634)
19～592.6180.54622.952<0.00113.706(4.697～39.999)
≥604.0550.74929.299<0.00157.661(13.283～250.315)
临床分型
轻型*-----
重型0.7040.4092.9650.0852.022(0.907～4.507)
住院日（d）
≤7*-----
>71.1770.35311.1200.0013.244(1.624～6.479)
陪护误工工作日（d）
≤7*-----
>72.1190.36034.598<0.0018.323(4.108～16.862)
发热
否*-----
是0.7200.3943.3430.0672.054(0.950～4.444)
咳嗽
否*-----
是0.9000.7081.6170.2042.460(0.614～9.852)
头疼
否*-----
是0.7060.5811.4780.2242.026(0.649～6.323)
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武汉市2023年肺炎支原体肺炎住院病例经济负担研究
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沈惠 1 , 陈邦华 1 , 余今菁 1 , 彭颖 1 , 张媛媛 1 , 李宏昀 1 , 杨莉 2 , 张丽杰 2
现代预防医学 | 卫生政策与管理 2025,52(19): 3573-3578
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现代预防医学 | 卫生政策与管理 2025, 52(19): 3573-3578
武汉市2023年肺炎支原体肺炎住院病例经济负担研究
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沈惠1, 陈邦华1, 余今菁1, 彭颖1, 张媛媛1, 李宏昀1, 杨莉2, 张丽杰2
作者信息
  • 1.武汉市疾病预防控制中心，湖北 武汉 430024
  • 2.中国疾病预防控制中心，北京 100050

    • 沈惠（1995—），女，硕士，公卫医师，研究方向：疾病预防与控制；

    陈邦华（1976—），男，硕士，主任医师，研究方向：现场流行病学；

通讯作者:

张丽杰，E-mail:
Economic burden of hospitalized cases of mycoplasma pneumonia in Wuhan in 2023
Hui SHEN1, Bang-hua CHEN1, Jin-jin YU1, Ying PENG1, Yuan-yuan ZHANG1, Hong-yun LI1, Li YANG2, Li-jie ZHANG2
Affiliations
  • Wuhan Center for Disease Control and Prevention, Wuhan, Hubei 430024,China
出版时间: 2025-10-10 doi: 10.20043/j.cnki.MPM.202502361
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摘要
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目的 了解武汉市2023年肺炎支原体肺炎（mycoplasma pneumoniae pneumonia,MPP）住院病例经济负担，为公共卫生防控政策制定和完善提供科学依据。方法 抽取武汉市2023年1—10月MPP住院病例为研究对象进行问卷调查，采用非参数检验分析不同组别患者因MPP住院造成的直接、间接及总经济负担的差异，同时采用多因素logistic回归分析影响经济负担相关因素。结果 共调查342例MPP住院病例，重型病例、具有发热以及咳嗽和头疼症状的住院病例总经济负担较高（P<0.001）。就诊远城区三级综合医院（OR=0.156，95%CI: 0.032～0.764）、年龄处于19～59岁（OR= 13.706，95%CI: 4.697～39.999）、≥60岁（OR=57.661，95%CI: 13.283～250.315）、住院日超过7日（OR=3.244，95%CI:1.624～6.479）、陪护误工工作日超过7日（OR=8.323，95%CI: 4.108～16.862）为影响总经济负担的相关因素（P<0.05）。结论 就诊于儿童专科医院、重型病例、具有发热以及咳嗽和头疼症状、年龄的增加、住院日以及陪护误工工作日的延长等因素，带给患者更沉重的经济负担，应加强临床诊疗、完善医疗保障体系等公共卫生政策干预，减轻患者经济负担。

肺炎支原体肺炎  /  经济负担  /  影响因素

Objective To understand the economic burden of hospitalized cases of mycoplasma p neumonia (MPP) in Wuhan in 2023, and to provide a scientific basis for the formulation and improvement of public health prevention and control policies. Methods A questionnaire survey was conducted on the hospitalized cases of MPP in Wuhan from January to October 2023. Non-parametric tests were used to analyze the differences in direct, indirect, and total economic burden among different groups of patients due to MPP. Multivariable Logistic regression was used to analyze the related factors affecting economic burden. Results A total of 342 cases of hospitalized MPP were investigated. The total economic burden was higher in severe cases and those with symptoms of fever, cough, and headache (P<0.001). Seeking medical treatment at a tertiary general hospital in a remote urban area (OR=0.156, 95% CI: 0.032-0.764), being aged 19-59 years (OR=13.706, 95% CI: 4.697-39.999), being aged ≥60 years (OR=57.661, 95% CI: 13.283-250.315), hospitalization lasting more than 7 days (OR=3.244, 95% CI: 1.624-6.479), and caregivers missing work for more than 7 days (OR=8.323, 95% CI: 4.108-16.862) were identified as factors associated with the total economic burden (P<0.05). Conclusion Visiting a children’s specialized hospital, severe cases, having symptoms of fever, cough, and headache, increasing age, length of hospital stay, and days of caregiver’s lost work all bring heavier economic burdens to patients. Public health policy interventions such as strengthening clinical diagnosis and treatment, and improving the medical security system should be strengthened to reduce the economic burden on patients.

Mycoplasma pneumonia  /  Economic burden  /  Influencing factors
沈惠, 陈邦华, 余今菁, 彭颖, 张媛媛, 李宏昀, 杨莉, 张丽杰. 武汉市2023年肺炎支原体肺炎住院病例经济负担研究. 现代预防医学, 2025 , 52 (19) : 3573 -3578 . DOI: 10.20043/j.cnki.MPM.202502361
Hui SHEN, Bang-hua CHEN, Jin-jin YU, Ying PENG, Yuan-yuan ZHANG, Hong-yun LI, Li YANG, Li-jie ZHANG. Economic burden of hospitalized cases of mycoplasma pneumonia in Wuhan in 2023[J]. Modern Preventive Medicine, 2025 , 52 (19) : 3573 -3578 . DOI: 10.20043/j.cnki.MPM.202502361
正文
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肺炎支原体肺炎（mycoplasma pneumoniae pneumonia, MPP）是由肺炎支原体（mycoplasma pneumoniae , MP）感染引起的肺部炎症。MPP是我国5岁及以上儿童最主要的社区获得性肺炎[1-2]，感染主要表现为发热、咳嗽和头疼等，随病情进展还可发展为危重症，甚至危及生命[3]。MPP感染常年均可发病[4]，发病高峰大多集中在冬、春、秋季，每3～5年可出现一次流行高峰[5]，2023年秋季，全国多地出现了MPP感染人数激增的情况[6-8]。为进一步了解武汉市MPP住院及其经济负担，本研究于2023年11月组织开展了武汉市2023年1—10月MPP住院病例经济负担的调查，为本地区MPP相关公共卫生防控政策的制定和完善提供科学依据。
1　对象与方法
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1.1　调查对象
武汉市市区、远城区三级综合医院和儿童专科医院各一家的MPP住院患者。
1.2　样本量计算
，Z取 1.96，α=0.05双侧；σ为定量数据的标准差；δ为允许绝对误差。本研究参数使用现有文献中MPP治疗费用[9]作为参数估计值，使用参数σ取309元，δ取35元。由样本量计算公式得到需有效调查300例，此时基本满足10%的允许误差。若考虑失访，在此基础上增加50%左右，即450例。
1.3　抽样方法
采用分层随机抽样方法，通过武汉市新突发传染病平台获取三家医疗机构MPP住院病例，先按照医疗机构分层，每层产生随机数的方法抽取随机数值前150例调查对象，共抽取450例病例纳入调查对象。最终调查完成342例，应答率76%。
1.4　方法
1.4.1　问卷调查
自行设计《MPP住院病例经济负担调查问卷》采用电话流调方式进行调查，调查表内容包括病例基本信息、医疗费用情况、非医疗费用情况等方面。
1.4.2　经济负担
疾病经济负担包括直接和间接经济负担。直接经济负担包括直接医疗费用（在院诊疗费、检查化验费等）和直接非医疗费用（患者及其陪护就医期间的食宿费、交通费和营养费）；间接经济负担是指患者及其陪护因病误工而损失的收入（如因患者及其陪护因年龄小或已退休等不存在误工天数的情况，则为0），计算可采用人力资本法[10]，间接经济负担=（误工天数×年人均可支配收入或年人均纯收入）/365。年人均可支配收入采用武汉市2023年居民人均可支配收入[11]。
1.5　统计学方法
根据性别、年龄等对数据进行分组，采用中位数及上下四分位数对各组直接、间接及总经济负担进行统计描述，所有数据采用SPSS 25.0软件进行分析。采用非参数检验（Kruskal Wallis检验比较多组和Mann-Whitney U检验比较两组）分析不同组别患者因MPP导致的经济负担差异，同时采用多因素logistic回归分析影响经济负担的相关因素。检验水准α=0.05。
1.6　质量控制
前期查阅大量相关文献，经专家咨询后设计问卷，并进行预调查调整完善问卷。选择以公共卫生专业背景的疾控中心人员为调查员，并进行统一培训。调查资料采用Epidata进行双录入双核查，防止错录和漏录。
2　结果
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2.1　病例基本情况
342例MPP住院病例发病、住院日期从7月开始呈现上升趋势，在10月达到高峰，见图1。男女性别比为1.15。病例以≤5岁学龄前儿童（113例，33%）和6～18岁学龄期青少年（135例，39%）为主。临床分型上，主要为轻症患者，285例（83%）。病例症状分布上，咳嗽、头疼、流涕为主。人均住院日为（6.28±3.89）d。见表1。
2.2　直接经济负担
如表2所示，远城区三级综合医院直接经济负担最低、市区三级综合医院最高，差异存在统计学意义（P<0.001）。重型病例、无陪护、具有发热、咳嗽、头疼、咽痛四种症状的住院病例直接经济负担较高（P<0.05）。不同年龄段中，≥60岁病例直接经济负担最高（P<0.001）。住院日超过7 d，直接经济负担较高（P<0.001）。见表2。
2.3　间接经济负担
儿童专科医院、重型、具有头痛症状的MPP住院病例间接经济负担较高（P<0.05）。不同年龄病例的间接经济负担之间差异存在统计学意义（P<0.001），住院日超过7 d、病人误工或缺课工作日超过7 d、陪护误工工作日超过7 d的间接经济负担较高（P<0.05），陪护人数越多，间接经济负担越高（P<0.001）。见表2。
2.4　总经济负担
市区三级综合医院、重型病例、具有发热以及咳嗽和头疼症状的MPP住院病例总经济负担较高（P<0.001），见表2。不同年龄段中，≥60岁病例总经济负担最高（P<0.001）。住院日超过7 d、陪护误工工作日超过7 d，病例的总经济负担较高（P<0.001）。
2.5　总经济负担的影响因素分析
以MPP住院病例的总经济负担（费用）为因变量，以医疗机构、年龄、临床分型、住院日、陪护误工工作日、是否发热、是否咳嗽、是否头疼作为自变量进行多因素logistic回归分析，因变量赋值以人均总经济负担的中位数（8 015.00）为分界值，大于中位数赋值为1（高负担），小于等于中位数赋值为0（低负担）。结果显示，就诊远城区三级综合医院（OR=0.156，95%CI: 0.032～0.764）、19～59岁病例（OR=13.706，95%CI: 4.697～39.999）、≥60岁病例（OR=57.661，95%CI: 13.283～250.315）、住院日超过7 d（OR=3.244，95%CI: 1.624～6.479）、陪护误工工作日超过7 d（OR=8.323，95%CI:4.108～16.862）为影响总经济负担的相关因素（P<0.05）。见表3。
3　讨论
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MPP在我国不属于法定报告传染病，且近年来发病率呈现逐年攀升趋势，占社区获得性肺炎患者近十分之一[12]，目前针对MPP疾病经济负担的研究较少，本研究通过对342例住院MPP病例的调查，了解武汉市MPP住院情况以及因住院导致的经济负担，对于MPP公共卫生防控策略提供数据支撑。
本研究共调查342例住院MPP病例，其中轻症和重症的人均总经济负担中位数分别为7 725.76和10 308.51元，占武汉市2023年居民人均可支配收入[11]的14%和18%，造成较重经济负担，低于2019—2023年上海市MPP均次住院费用[8]，高于2023年青岛市每例MPP住院期间总经济负担[13]。这可能与各地的经济发展水平和物价水平有关。
本研究显示，重型病例的MPP住院病例直接与总经济负担较高，这可能是MPP重症病例可能会存在严重的肺内和肺外并发症[2,14]，使得病程和住院日的延长以及治疗手段的复杂化，从而增加直接经济费用，也导致更高的总经济负担。另外，本研究提示，年龄越大，直接和总经济负担越重。这可能是老年人本身合并基础疾病较多，自身免疫力低下，较易出现严重的肺内和肺外并发症[15-16]，预后差，从而导致住院时长及住院费用增加，进一步给家庭带来更沉重的直接和总经济负担。因此，应重视对老年人群的健康宣教，有助于其对重症MPP预防和预后，进而减少住院日，降低医疗花费。此外，多因素logistic回归分析显示，造成MPP住院高经济负担主要危险因素是就诊医疗机构、年龄、住院日、陪护误工工作日。提示就诊于儿童专科医院、年龄的增加、住院日以及陪护误工工作日的延长等因素，带给患者更高的经济负担。儿童因为心智发展尚未成熟，独立生活能力差，对父母长辈依赖程度较高[17]，因此增加了陪护者误工费用，也进一步加重住院经济负担，可能是就诊于儿童专科医院的病例间接经济负担较高的原因。MPP住院病例的经济负担与住院日呈现正相关，住院日越长，往往意味着病情复杂、治疗周期长，相应医疗资源和费用投入也会更多，这与杨爱民[18]、邱静梅[19]以及薛同斌[20]等学者的研究相似。
鉴于MPP给个人、家庭和社会带来沉重经济负担，建议应加强以下几点工作：（1）相关部门要加强MPP监测预警；（2）积极推动肺炎相关疫苗纳入免疫规划中，提高高风险人群如儿童、老年人及慢性病患者疫苗接种率，降低因MPP继发和合并其他细菌性肺炎导致的重症，减轻疾病负担；推动MPP疫苗的研发工作，以期早日免疫接种推广，有效防控MPP疫情；（3）临床诊疗上应加强对老年病例综合全科的诊疗策略，预防并发症和合并感染导致重症的风险；（4）完善医疗保障体系，适当提高医保报销比例，减轻患者经济负担；（5）加强MPP的健康宣教，提高民众科学防护能力，做到早发现、早预防、早治疗。
本研究基于武汉市三家医疗机构的MPP住院病例调查，研究样本量较少，因此本研究无法代表所有MPP病例群体的经济负担。另外，由于调查时间限制，本研究只收集到武汉市2023年1—10月的住院病例，仅探讨了直接和间接经济负担，未考虑无形经济负担的测算，存在一定的局限性，可能影响最终本次经济负担的测算结果。
基金
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  • 国家重点研发计划(2024YFC2311500)
  • 国家自然科学基金(82341034)
  • 中国现场流行病学培训项目(102393220020010000027)
  • 国家疾病预防控制局-公共卫生人才培养支持项目(01063)
  • 武汉市公共卫生重点学科-《新（突）发传染病监测预警》
文献
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参考文献 引证文献
排序方式：
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Wang ZG, Ji Y, Zhang J, et al. Investigation on atypical pathogens related with community acquired pneumonia and the factors associated with mycoplasma pneumoniae infection in Jiangsu, China[J]. Clinical Laboratory, 2020, 66(6): 36.
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中华人民共和国国家卫生健康委员会，赵顺英，钱素云，等.儿童肺炎支原体肺炎诊疗指南(2023年版)[J].新发传染病电子杂志，2024，9（1）：73-79.
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2025年第52卷第19期
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doi: 10.20043/j.cnki.MPM.202502361
  • 接收时间：2025-02-20
  • 首发时间：2026-03-17
  • 出版时间：2025-10-10
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  • 收稿日期：2025-02-20
基金
国家重点研发计划(2024YFC2311500)
国家自然科学基金(82341034)
中国现场流行病学培训项目(102393220020010000027)
国家疾病预防控制局-公共卫生人才培养支持项目(01063)
武汉市公共卫生重点学科-《新（突）发传染病监测预警》
作者信息
    1.武汉市疾病预防控制中心，湖北 武汉 430024
    2.中国疾病预防控制中心，北京 100050

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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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